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Zhonghua Wei Chang Wai Ke Za Zhi =... Jul 2022
Topics: Anastomosis, Surgical; Anastomotic Leak; Drainage; Gastrectomy; Humans; Suction
PubMed: 35844126
DOI: 10.3760/cma.j.cn441530-20220424-00177 -
Advances in Clinical and Experimental... Nov 2023Chest tube drainage during pulmonary surgery is fundamental to removing air and fluid, as well as for lung re-expansion. However, the advantages of adding external... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chest tube drainage during pulmonary surgery is fundamental to removing air and fluid, as well as for lung re-expansion. However, the advantages of adding external suction to the water seal are under debate.
OBJECTIVES
The aim of the study was to conduct a meta-analysis in order to assess the effects of adding suction to a simple water seal on the outcomes of lung surgery.
MATERIAL AND METHODS
A search of the literature up to November 2021 found 14 studies with 2449 lung surgery patients. Of these patients, 1092 received suction drainage and 1357 received a simple water-seal drainage. The studies reported the effects of adding suction to a simple water seal on postoperative outcomes after lung surgery. A randomor fixed-effect model determined the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (95% CIs) to compare the outcomes.
RESULTS
In patients undergoing lung surgery, suction resulted in a substantially longer chest tube duration (MD = 0.74, 95% CI: 0.90-1.40, p = 0.03, Z = 2.21) and a smaller postoperative pneumothorax (OR = 0.27, 95% CI: 0.13-0.59, p = 0.02, Z = 2.24) than a simple water seal. However, no differences existed in prolonged air leak (p = 0.91, Z = 0.12), air leak duration (p = 0.28, Z = 1.07) or length of hospital stay (p = 0.23, Z = 1.2) between the 2 approaches.
CONCLUSION
Suction led to considerably longer chest tube duration and lower postoperative pneumothorax, but no significant difference in sustained air leak, air leak duration or length of hospital stay was observed compared to a simple water seal in patients undergoing pulmonary surgery. Further research is needed to validate these findings and increase confidence, particularly regarding the postoperative pneumothorax results.
Topics: Humans; Chest Tubes; Drainage; Pneumothorax; Suction; Water
PubMed: 37026974
DOI: 10.17219/acem/161491 -
Clinical Orthopaedics and Related... Mar 1991A prospective investigation was performed to determine when to remove a suction drain following total knee arthroplasty (TKA). Forty-one TKAs were randomly allocated to... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
A prospective investigation was performed to determine when to remove a suction drain following total knee arthroplasty (TKA). Forty-one TKAs were randomly allocated to closed suction drainage for either 24 or 48 hours. The drain was removed and the tip was cut off and processed by a method giving quantitative cultures. In the 48-hour group, 85% of the total volume was drained during the first 24 hours. During the following 24-hour period, a mean volume of only 50 ml was drained. No organism was isolated from cultures of drain tips sampled at 24 hours. However, at 48 hours, 25% of the drain tips yielded light growths of coagulase-negative staphylococci (four drain tips) and Staphylococcus aureus (one drain tip). Clinical evaluations of wound healing were comparable in the two groups. Clearly, nothing is to be gained by continuing drainage beyond 24 hours. If drainage is maintained for longer periods, there is an increased risk of contamination by bacteria.
Topics: Equipment Contamination; Humans; Knee Prosthesis; Prospective Studies; Staphylococcus; Suction; Surgical Wound Infection; Time Factors; Wound Healing
PubMed: 1997239
DOI: No ID Found -
Acta Orthopaedica Apr 2011Drainage after surgery is commonly used, and the contents are generally discarded as clinical waste. We analyzed closed suction drainage fluid from hip arthroplasty...
BACKGROUND AND PURPOSE
Drainage after surgery is commonly used, and the contents are generally discarded as clinical waste. We analyzed closed suction drainage fluid from hip arthroplasty patients to determine whether any multipotent stem cells were present that could be used as a source of cells for tissue regeneration.
METHODS
Drainage fluid was obtained from 14 patients after hip arthroplasty on the day of surgery, the next day, and 2 days after surgery. Peripheral blood and bone marrow from the iliac crest were also obtained from the same patients during surgery. These samples were examined using regular flow cytometric profiling, and we performed quantitative immunoassays of stromal-derived factor-1 (SDF1) levels in the plasma. Mononuclear cells (MNCs) from these samples were also isolated and cultured. Fibroblastic adherent cells from MNC fractions were cultured in an osteogenic and a chondrogenic differentiation medium and were then evaluated for multipotentency.
RESULTS AND INTERPRETATION
Fibroblastic adherent cells were isolated from the mononuclear cell fraction of bone marrow and drainage fluid on the day of surgery, but they were not present in either the mononuclear cell fraction of the peripheral blood or the drainage fluid on the next day and 2 days after surgery. The cells from the drainage fluid on the day of surgery could differentiate in vitro into osteogenic and chondrogenic cells. SDF1 was elevated on the day of surgery, while CXCR4 was elevated on that day and the next day. This suggests that locally-induced SDF1 contributes to the mobilization of circulating CXCR4-positive cells. These results show that the drainage fluid collected on the day of surgery contains stem/progenitor cells that could be used for autologous cell-based therapy.
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Cell Differentiation; Cell Separation; Female; Humans; Immunophenotyping; Male; Middle Aged; Multipotent Stem Cells; Postoperative Care; Suction; Surgical Wound Infection; Time Factors; Wound Healing
PubMed: 21434846
DOI: 10.3109/17453674.2011.566153 -
Haemophilia : the Official Journal of... Jul 2017Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb. (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb.
AIM
We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser.
METHODS
In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included. The study group consisted of 88 patients (108 knees), in which we did not insert suction drain and the control group included 88 patients (106 knees), in which drain was inserted at the end of the surgery. All patients underwent TKA via anterior knee incision and medial parapatellar approach.
RESULTS
The mean follow-up period of study group and control group was 21 ± 11 months vs. 20 ± 9 months consecutively (P = 0.54). The mean hospital stay was 13 ± 8 days vs. 14 ± 8 days in study and control group consecutively (P = 0.40). In both groups, the major part of improvement in clinical knee society score was due to increase in pain subset (mean increase of 42 vs. 39 points consecutively) and to a lesser extent to alleviation of flexion contracture (mean increase of 13 vs. 15 points consecutively). We observed no differences in the mean visual analogue scale (VAS) value between both groups. Average functional outcome in both groups improved during follow-up visits.
CONCLUSION
We can conclude that there is no rationale for the use of drain after primary TKA.
Topics: Adult; Arthroplasty, Replacement, Knee; Case-Control Studies; Female; Hemophilia A; Humans; Joint Diseases; Male; Middle Aged; Postoperative Complications; Suction
PubMed: 28544490
DOI: 10.1111/hae.13224 -
Journal of Nippon Medical School =... Dec 2008The duration of suction drainage in patients undergoing breast cancer surgery is difficult to predict. The uncertainty this poses may complicate the development of a...
BACKGROUND
The duration of suction drainage in patients undergoing breast cancer surgery is difficult to predict. The uncertainty this poses may complicate the development of a clinical pathway for patients with breast cancer. In this study we attempted to identify factors that may influence the duration of suction drainage in patients undergoing breast cancer surgery.
METHODS
We examined the relationships between the duration of suction drainage and several clinical factors including type of drainage tube in 60 patients with primary breast cancer who underwent surgical resection at the Nippon Medical School Hospital in 2004 and 2005. The drainage tubes were removed 1 day after the daily drainage volume had decreased to less than 50 mL or on the seventh postoperative day in patients in whom such a decrease did not occur. All patients were discharged from the hospital 1 or 2 days after the drains were removed.
RESULTS
Seroma was observed in all patients. No complications associated with the drainage were observed. The median duration of drainage was 4.5 days, and the range was 2 to 7 days. Univariate analyses revealed significant relationships between the duration of drainage and the following 5 factors: patient age at surgery, body mass index, intraoperative blood loss, operation time, and type of surgery (total breast resection or partial breast resection). Univariate and multivariate analyses showed no significant statistical associations between the duration of drainage and the other factors, including the type of drainage tube.
CONCLUSION
None of the factors examined was strongly associated with the duration of drainage. This study has shown that any type of drainage tube can be used in breast cancer surgery, in regards to the duration of drainage, and that patient discharge 1 or 2 days after drainage tube removal is appropriate.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Blood Loss, Surgical; Body Mass Index; Breast Neoplasms; Female; Humans; Mastectomy; Middle Aged; Suction; Time Factors
PubMed: 19155569
DOI: 10.1272/jnms.75.332 -
Annals of Plastic Surgery Sep 2020Biological glue is already used as a hemostatic agent and tissue adhesive in plastic surgery. This study evaluates the use of this glue as an alternative to suction...
INTRODUCTION
Biological glue is already used as a hemostatic agent and tissue adhesive in plastic surgery. This study evaluates the use of this glue as an alternative to suction drainage for the adhesion of tissue-expanded flaps in pediatric patients.
METHODS
This is a retrospective, multicenter case-control study on 48 flap procedures conducted on 42 children (5 months-12 years of age) between 2004 and 2017, comparing a "glue" group (n = 24) with a control group (n = 24), in which a classic redon drain was used. The control patients were matched according to age, etiology, location of the lesion, and the size of the expander. The primary end point was the duration of hospital stay.
RESULTS
The conditions were 24 cases of congenital nevus, 14 of cicatricial alopecia, and 10 of sebaceous hamartoma. Twenty-nine lesions were located on the scalp, 15 on the back, 2 on the thigh, and 2 on the buttocks.The average surgical durations (48 ± 24 vs 63 ± 32 minutes, P = 0.13) and average room occupancy time (126 ± 21 vs 139 ± 44 minutes, P = 0.29) were similar between the glue group and the control group. However, the average duration of hospital stay was lower in the glue group (1.5 ± 1.5 days) than in the control group (3.6 ± 1.3 days, P < 0.0001). The complication rates between the groups were similar.
CONCLUSIONS
The application of glue on expanded flaps is as reliable as suction drainage with the advantage of reducing the duration of hospital stay and potentially enabling outpatient treatment for certain patients.
Topics: Case-Control Studies; Child; Cost-Benefit Analysis; Drainage; Fibrin Tissue Adhesive; Humans; Retrospective Studies; Suction; Surgical Flaps
PubMed: 32788564
DOI: 10.1097/SAP.0000000000002457 -
Lancet (London, England) Dec 1962
Topics: Drainage; Humans; Suction
PubMed: 13940488
DOI: 10.1016/s0140-6736(62)91062-0 -
European Spine Journal : Official... Mar 2013The efficacy of closed-suction drainage in primary intradural spinal cord tumor surgery has not been addressed. We investigated whether closed-suction drainage is...
PURPOSE
The efficacy of closed-suction drainage in primary intradural spinal cord tumor surgery has not been addressed. We investigated whether closed-suction drainage is essential after primary intradural spinal cord tumor surgery.
METHODS
From January 2003 to October 2011, 169 consecutive patients with primary intradural spinal cord tumors operated by a single surgeon were selected. Closed-suction drainage was inserted in patients before August 2007, but was not used after August 2007. After removal of tumor and meticulous hemostasis, the opened dura was closed and made watertight using 4-0 silk with interrupt suture and 1.0 cm(3) of surgical glue was applied in common. Closed-suction drainage was inserted below the muscular fascia in 75 patients (group I, M:F = 39:36; 46.20 ± 15.63 years) and was not inserted in 94 patients (group II, M:F = 46:48; 51.05 ± 14.89 years).
RESULTS
Neurological deficit precluding ambulation did not occur in all patients. Between group I and II, there were no significant differences in body mass index (22.75 ± 3.16 vs. 23.51 ± 3.22 kg/m(2); p = 0.13), laminectomy level (2.45 ± 1.46 vs. 2.33 ± 1.91; p = 0.65), operation time (260.65 ± 109.08 vs. 231.52 ± 90.08 min; p = 0.06), estimated intraoperative blood loss (456.93 ± 406.62 vs. 383.94 ± 257.25 cm(3); p = 0.18), and hospital stay period (9.25 ± 5.01 vs. 9.35 ± 5.75 days; p = 0.91). Two patients in group I underwent revision surgery due to wound problems, while revision surgery was not performed in group II (p = 0.20).
CONCLUSION
Closed-suction drainage may not be essential after primary intradural spinal cord tumor surgery.
Topics: Adult; Aged; Female; Humans; Laminectomy; Male; Middle Aged; Postoperative Care; Spinal Cord Neoplasms; Suction; Treatment Outcome
PubMed: 23001449
DOI: 10.1007/s00586-012-2504-8 -
Shanghai Kou Qiang Yi Xue = Shanghai... Dec 2014To evaluate the clinical value of suction drainage to prevent fistula after parotidectomy, and seek the best opportunity to remove the drainage according to the draining... (Clinical Trial)
Clinical Trial
PURPOSE
To evaluate the clinical value of suction drainage to prevent fistula after parotidectomy, and seek the best opportunity to remove the drainage according to the draining output and duration.
METHODS
One hundred and ninety-four patients with parotid diseases after superficial parotidectomy were assigned into pressure dressing group and suction drainage group. Pressure dressing was used after suction drainage tube was removed in the pressure group, while suction drainage tube was fixed through the process in the suction group. Postoperative salivary fistula occurrence between the 2 groups was analyzed with Pearson chi-square test, and the contribution of the output and duration resulting in salivary fistula was analyzed by Fisher's exact test with SPSS 19.0 software package.
RESULTS
The occurrence of salivary fistula in the pressure dressing group and suction group was 11.6% and 15.5%, respectively in the suction group. No significance difference was found between the 2 groups (P>0.05). In the suction drainage group, significant correlation of the draining duration and salivary fistula was not found (P>0.05). However, the draining output less than 20 mL resulted in lower salivary fistula rate compared with the draining output of 20-30 mL.
CONCLUSIONS
According to our findings, suction drainage can be used as a substitute for pressure dressing after parotidectomy in preventing salivary fistula, and the best timing of drainage extubation is when the draining output is less than 20 mL within 24 hours.
Topics: Drainage; Fistula; Humans; Parotid Gland; Postoperative Complications; Suction
PubMed: 25636298
DOI: No ID Found